Clarendon House, 2 Church Street Hamilton HM 11, Bermuda P: +1.212.791.3933 Customer Account Information Thank you for choosing FXDD Trading FXDD. To make it easy and convenient to open your account, we ve included all the necessary forms in this application packet. The instructions to complete your account approval process are: Step 1: Complete the Customer Account Application and SIGN the Customer Application. Carefully read the Customer Agreement, the Risk Disclosure Statement and the Trading Rules and Regulations. SIGN the acknowledgement for the Customer Agreement, Risk Disclosure Statement and Trading Rules and Regulations. Submit the completed and signed Customer Account Application (in its entirety) and the Signature Page for the Customer Agreement, Risk Disclosure Statement and Trading Rules and Regulations. Step 2: Verify & Submit Additional Personal Information. Please submit two (2) forms of identification, including one (1) photo ID (i.e. passport), AND one (1) proof of address as represented on this application (i.e. recent utility bill, bank statement, etc.). Required of all authorized signatories on this account. Step 3: Send your completed, signed application (in its entirety), the Customer Agreement, Risk Disclosure Statement, Trading Rules and regulations and applicable tax form, along with required photo ID(s) to FXDD: via e-mail (for expedited processing) ATTN: New Accounts applications@fxddtrading.com Step 4: Fund Your Account. Cash deposits are not accepted, which includes money orders, traveler s checks or other cash equivalents. Under no circumstances will FXDD make or receive payments via third parties. There are five easy ways to fund your account: a) Wire Transfer - The fastest way to fund your account Bank wires are typically received and credited to client s account within 1-2 business days. Deposit Currency USD Bank of America USA (One Bryant Park New York, NY 10036 USA) Account Name (Beneficiary): FXDD BERMUDA LIMITED CUSTOMER INCOMING ACCOUNT Account #: 483043646569 Routing ABA: 026009593 SWIFT: BOFAUS3N 04/09/2015 Customer Account Information Page 1 of 6
b) Debit/Credit - Once received, funds are credited to client s account within 1-2 business days. 1. ACCOUNT APPLICATION Account Type: (Please check only one) Individual Account Corporate Account (Name) Trust (Name) Partnership (Name) Joint Account If Corporate, Registration Number: Introducing Broker (if any): COMPLETE THIS APPLICATION WITH PERSONAL INFORMATION FOR EACH DIRECTOR, SHAREHOLDER, CORPORATE OFFICER: Account Type (Please check one only): Platform Type (Please check one only): Mini (Leverage 200:1) Standard (Leverage 100:1) Micro (Leverage 200:1) Swordfish JForex Viking (Currenex) MetaTrader 4.0 MirrorTrader PowerTrader (Currenex) MTXtreme Initial Margin Deposit: $ (estimate) Email Address (Fill in below): 2. PERSONAL INFORMATION (PRIMARY ACCOUNT HOLDER, MANAGER, TRUSTEE, CUSTODIAN OR CORPORATE REPRESENTATIVE) - Required First Name: Middle Name: Last Name: Date of Birth (DD/MM/YYYY): Home Telephone: Home Address (P.O. Boxes are not accepted): City: State/Region: ZIP/Postal Code: ID Type: Driver License Passport National ID Card ID Number: U.S. Resident? YES NO If NO, what country? ***If you are over not between of age 18 and 65, you will be required to complete and sign an Additional Risk Disclosure Document (Applies to Primary and Co-Applicant) 04/09/2015 Customer Account Information Page 2 of 6
Skip this section if you are applying for an Individual Account 3. PERSONAL INFORMATION (CO-APPLICANT, OR ADDITIONAL CORPORATE REPRESENTATIVE) - Required First Name: Middle Name: Last Name: Date of Birth (DD/MM/YYYY): Home Telephone: Home Address (P.O. Boxes are not accepted): City: State/Region: ZIP/Postal Code: ID Type: Driver License Passport National ID Card ID Number: U.S. Resident? YES NO If NO, what country? 4. EMPLOYMENT STATUS (PRIMARY ACCOUNT HOLDER) - Required (Please check one) Employer s Name: Employed Self-employed Retired Other If you select Employed, please provide Employer and Position. If you select Self Employed, please provide Type of business. If you select Retired, Unemployed, Other, please provide Source of funds. Unemployed Nature of Business: Position: Source of Funds: Are you currently, or have you ever worked for a brokerage firm, bank, or financial institution? YES NO ***If you are using retirement funds for trading capital, in order for you to be considered for an FXDD trading account, you will be required to complete and sign an Additional Risk Disclosure Document (Applies to Primary and Co-Applicant) Skip this section if you are applying for an Individual Account 5. EMPLOYMENT STATUS (CO-APPLICANT) - Required (Please check one) Employed Self-employed Retired Other If you select Employed, please provide Employer and Position. If you select Self Employed, please provide Type of business. If you select Retired, Unemployed, Other, please provide Source of funds. Employer s Name: Unemployed Nature of Business: Position: Source of Funds: Are you currently, or have you ever worked for a brokerage firm, bank, or financial institution? YES NO 04/09/2015 Customer Account Information Page 3 of 6
6. FINANCIAL INFORMATION - Required Estimated Annual Income (in USD): Net Worth (in USD) (estimated total value of all your assets minus your liabilities): Customers should use only their own available Risk Capital for trading foreign exchange. Risk Capital means funds, which if lost, would not change your lifestyle or your family s lifestyle. This information is necessary to assist FXDD in assessing your suitability for trading foreign currencies. Completing the information will not have the effect of limiting you potential losses to the amount indicated. Have you ever declared bankruptcy? YES NO Bankruptcy Details ***If your annual income is less than $25,000 you will be required to complete and sign an Additional Risk Disclosure Document (Applies to Primary and Co-Applicant). 7. PREVIOUS TRADING & INVESTMENT EXPERIENCE - Required Please select one: I managed my own account Someone else managed my account I managed the accounts of others Foreign Exchange (Check one): Stocks/Equities & Stock Options (Check one): Bonds (Check one): Commodities & Futures and Future Options (Check one): Options (Check one): Select the volume in which you traded the following instruments: Foreign Exchange: Stocks/Equitites & Stock Options: $0 - $50,000 $50,001 - $100,000 $100,001 - $500,000 $500,001 and over $0 - $50,000 $50,001 - $100,000 $100,001 - $500,000 $500,001 and over Commodities & Futures and Future Options: $0 - $50,000 $50,001 - $100,000 $100,001 - $500,000 $500,001 and over Bonds: $0 - $50,000 $50,001 - $100,000 $100,001 - $500,000 $500,001 and over 04/09/2015 Customer Account Information Page 4 of 6
7. PREVIOUS TRADING & INVESTMENT EXPERIENCE - Required Select the frequency in which you traded: Foreign Exchange: weekly monthly quarterly semi-annually annually none Stocks/Equitites & Stock Options: Commodities & Futures and Future Options: Bonds: weekly monthly quarterly semi-annually annually none weekly monthly quarterly semi-annually annually none weekly monthly quarterly semi-annually annually none ***If you do not have at least 6 months of futures, securities, or foreign exchange investment or trading experience, in order for you to be considered for an FXDD trading account, you will be required to complete and sign an Additional Risk Disclosure Document (Applies to Primary and Co-Applicant). 8. MISCELLANEOUS ACCOUNT INFORMATION - Required Will any person or entity other than the applicants of this account have control over or manage the trading account? If please list the name(s) and relationship(s): Will any person or entity other than the account holder, and joint account holder, have a financial interest in the account? If please list the name(s) and relationship(s): Has there been, or is there currently, pending litigation between you and ANY brokerage firm, exchange, state or federal agency, Forex firm, securities firm or registered representative of any of the preceding? Are you a Politically Exposed Person or related to a Politically Exposed Person or close associate to a Politically Exposed Person? 04/09/2015 Customer Account Information Page 5 of 6
9. SIGNATURES - Required CUSTOMER ACCOUNT APPLICATION ACCEPTANCE By checking I AGREE you acknowledge that you have read and filled out this Customer Account Application and that you certify, represent and warranry that the information provided us correct and complete. I Agree NON-SOLICITATION ACCEPTANCE By checking I AGREE you acknowledge that, the funds to be deposited in my account are my property and have not been solicited from a third party. I Agree CUSTOMER INFORMATION: I (We) hereby represent that the information provided in this application document is true and correct. I (We) further represent that I (We) will notify FXDD of any material changes in writing. FXDD reserves the right, but has no duty, to verify the accuracy of information provided, and to contact such bankers, brokers and others as it deems necessary. Account Holder Signature Joint Account Holder Signature (If Applicable) Print Client Name Print Client Name Date (DD/MM/YYYY) Date (DD/MM/YYYY) Please sign and scan a copy to applications@fxddtrading.com 04/09/2015 Customer Account Information Page 6 of 6